Anatomy-based fitting for cochlear implant recipients

OF REVIEW: Frequency-to-place mismatch is the discrepancy between the frequency information delivered by a cochlear implant electrode and the natural cochlear place frequency location that is stimulated. Frequency-to-place mismatch has been shown to negatively influence cochlear implant outcomes....

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Audiologists fitting cochlear implants should be aware of anatomy-based fitting strategies — including imaging-guided frequency mapping — as emerging evidence suggests they can reduce frequency-to-place mismatch and potentially improve speech and music outcomes, though wider clinical adoption awaits standardized protocols and tool availability.

Addressing the frequency-to-place mismatch through individualized, anatomy-guided CI programming represents a meaningful shift from one-size-fits-all fitting toward precision audiology that could improve hearing outcomes for implant recipients.

1. 01Standard cochlear implant fitting often ignores individual anatomical variation in cochlear tonotopy (the map of pitches in the cochlea).
2. 02Frequency-to-place mismatch — where electrodes stimulate the wrong pitch region — impairs speech and music perception.
3. 03Anatomy-based fitting uses imaging (e.g., CT) to map electrode positions and adjust frequency allocations accordingly.
4. 04Review synthesizes current strategies and evidence for personalized CI fitting based on cochlear anatomy.
5. 05Wider clinical implementation requires standardized imaging workflows and fitting software integration.

PMID

42515849

DOI

10.1097/MOO.0000000000001146.

Journal

Current Opinion in Otolaryngology & Head and Neck Surgery

Publication type

review

Evidence level

5

Population

Cochlear implant recipients across age groups

Intervention

Anatomy-based frequency-allocation fitting for cochlear implants

Comparator

Standard (non-individualized) cochlear implant fitting